Responding to the Government’s ‘Final report on progress to address COVID-19 health inequalities’1 published today, Dr Chaand Nagpaul, BMA council chair, said:
“Since the launch of this series of reports, over a year ago, there has been great expectation placed on the final report from the Government about what it is doing to address the devastating and disproportionate impact Covid is having on people from ethnic minority backgrounds. While we welcome Government attention on reducing health inequalities, the BMA finds the report unacceptably disappointing as it lacks in addressing the impact that Covid has had on NHS staff from ethnic minority communities.
“Rightly so, this report calls on at risk groups to get booster jabs and identifies the vaccination programme as the most significant measure to saving lives and protecting people from ethnic minority backgrounds from Covid. The report also highlights commendable efforts made by the Government to engage with ethnic minority communities on the vaccine. However, it’s simply no good to keep ploughing away with communication efforts to increase uptake without addressing the reasons behind differential uptake rates – the elephant in the room. This report fails to acknowledge the role of institutional and societal racism in the experience of ethnic minorities both before and during this pandemic.
“The report does, however, identify that one of the main factors behind the higher risk of Covid infection for those from ethnic minority backgrounds is occupation, particularly for those in frontline roles, such as NHS workers. It is therefore beyond reason as to why it only briefly refers to the NHS workforce and fails to even reference the disproportionate Covid mortality rate for ethnic minority doctors. Doctors from ethnic minority backgrounds make up 40% of the medical workforce, but account for over 85% of doctors that have died from Covid* – with the majority being International Medical Graduates. Is it entirely inexcusable that this has been missed out of the report when the figures are so stark. The Association has consistently called on the Government to investigate the reasons behind the disproportionate mortality rate for ethnic minority healthcare staff. By ignoring this without addressing this crucial issue, the report fails to address a major inequality facing the NHS workforce.
“For some time now, the BMA has raised concerns with the Government about how NHS culture may have contributed to the disproportionate mortality rate of ethnic minority and International Medical Graduates doctors. Some of the areas in which the report is lacking are:
- Personal Protective Equipment: This report says that having an appropriately fitted mask is essential for effective protection but fails to mention the problems that many ethnic minority, female and religious NHS staff had in procuring appropriate PPE at the beginning of the pandemic. It does mention a project carried out, which we commended at the time, to ensure supply of masks to fit the diverse needs of the medical workforce but the project came about far too late. The report also fails to address the fact that many ethnic minority doctors were placed in situations where they felt forced to see patients despite not having adequate PPE. A BMA survey done in April 20202 found that nearly twice the number of ethnic minority doctors, compared to white doctors, reported feeling pressured to see patients without adequate PPE.
- Risk assessments: This report frames the provision of risk assessments as a success story, but it is not enough to simply praise the number of risk assessments carried out. BMA surveys show that many ethnic minority doctors felt as though these risk assessments were inadequate and often not acted upon. The BMA has consistently shared concerns about risk assessments with the Government, including the details from our January 2021 survey3 which found that ethnic minority doctors were less likely to say that appropriate adjustments had been made following their risk assessments.
- NHS Culture: The BMA has consistently called for actions to be taken to develop a more inclusive NHS culture and throughout the pandemic we raised concerns about our survey findings4 that ethnic minority doctors felt less confident to speak up about safety concerns. However, this report totally fails to explore this issue.
“While this report makes recommendations for the future and describes work in several areas that the BMA had long been calling for – such as some community initiatives and improving the way deaths are recorded – it remains unclear how these recommendations and their implementation will be monitored. It is essential that the independent public inquiry into Covid and the Government’s forthcoming response to the CRED report explores these issues for all of the NHS workforce. The lives and health of ethnic minority people and healthcare staff are depending on the Government to take this issue seriously and put together a robust action plan.”
Notes to editors
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.
- BAME doctors hit worse by lack of PPE
- BMA survey shows, a year on, Black, Asian and other minority ethnicity doctors still don’t feel protected from Coronavirus in the workplace
- Caring, supportive, collaborative: a future vision for the NHS
* The figure of over 85% of doctors that have died from Covid is based on data that the BMA has compiled from media reports and member information: https://www.bmj.com/covid-memorial